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CMAG

Notes

46

Performance Measures/Standards NCQA Standards

NQF-Endorsed™ National Voluntary Consensus Standards for Physician- Focused Ambulatory Care: NCQA Measures published in July 200786 list the following as standards:

AntiDepressant Medication Management

  • Optimal Practitioner Contacts for Medication Management

    • Percentage of patients who were diagnosed with a new episode of depression and treated with antidepressant medication and who had at least three follow-up contacts with a practitioner during the 84-day (12-week) Acute Treatment Phase.

  • Effective Acute Phase Treatment

    • Percentage of patients who were diagnosed with a new episode of depression, were treated with antidepressant medication and remained on an antidepressant drug during the entire 84-day Acute Treatment Phase.

  • Effective Continuation Phase Treatment

    • Percentage of patients who were diagnosed with a new episode of depression and treated with antidepressant medication and who remained on an antidepressant drug for at least 180 days.

In addition to these standards, there are prevention, medication management, ADHD, and substance abuse standards which may apply.

HEDIS Standards HEDIS measures include the following:87

Antidepressant Medication Management

  • Adults age 18 and older diagnosed with a new episode of depression and treated with an antidepressant drug

    • Three follow-up visits to monitor progress, including one with a prescribing practitioner, during the 84-day (12 weeks) acute treatment phase = Optimal Practitioner Contacts

    • Remained on an antidepressant medication during the 12 weeks following diagnosis = Effective acute-phase treatment

    • Remained on an antidepressant medication for at least six months following diagnosis = Effective continuation-phase treatment

  • Follow-up visit after hospitalization for mental illness

    • Members, age 6+ discharged from an inpatient mental health hospitalization

      • Had one follow-up visit within seven days of hospital discharge

      • Had one follow-up visit within 30 days of hospital discharge

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